Individual
KEN NGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
12503 SE MILL PLAIN BLVD STE 222, VANCOUVER, WA 98684-4008
(503) 987-0425
Mailing address
12503 SE MILL PLAIN BLVD STE 222, VANCOUVER, WA 98684-4008
(503) 987-0425
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2020021919
MO
122300000X
Dentist
Primary
70024796
WA
Other
Enumeration date
07/16/2020
Last updated
03/18/2026
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